RESTLESS LEGS SYNDROME (333.94) Restless legs syndrome or RLS is a DSM-V sleep-wake disorder that involves having an uncomfortable, creeping, tingling, or crawling sensation on the legs that is only relieved with moving the legs. This results in a continual urge to move one’s legs. It usually starts in the evening, particularly around sleep time. The patient will be unable to sleep because of a need to move their legs. It is related to anxiety or to a medical problem, and results in poor sleep maintenance, daytime fatigue, and non-restorative sleep. There are five criteria for the disease, including the following: •
The urge to move the legs with uncomfortable leg sensations relieved partially by moving them.
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Symptoms occurring three times weekly for a minimum of three months.
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Distress or impairment in functioning
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A lack of another disease that could explain the symptoms.
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A lack of drug use or alcohol use explaining the symptoms.
The typical age at onset is in the 20s and 30s, with worsening symptoms with age. It is not often seen in children (with about a two percent incidence in children). The overall prevalence is 2-7 percent, with a slight preponderance of women at 1.5-2 times more than men. It increases with a family history of the disorder and in pregnancy. There are several brain pathways and systems suspected as being causative. Typical comorbidities include depressive disorders, anxiety disorders, and things like ADD/ADHD. Migraine headaches increase the prevalence of restless legs syndrome, as does bruxism. Treatment for RLS will also treat bruxism symptoms. A total of 80 percent of people with RLS will have Periodic Limb Movement Disorder (PLMD), in which sleep is disrupted by the presence of twitching or jerking movements of the extremities.
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